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Proyectos de investigación

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14595/812

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    Desenlaces funcionales y oncológicos en pacientes con lesiones metastásicas únicas óseas llevados a metastasectomía
    (Clinical Orthopaedics and Related Research (CORR), 2025) Narvaez Rodriguez, Gabriel
    Introduction: Solitary bone metastases represent a major clinical challenge. Surgical metastasectomy remains a valid option in selected patients. This study evaluated the oncologic and functional outcomes following metastasectomy in a cancer referral center in Bogotá, Colombia. Methods: A retrospective observational study including patients with solitary bone metastases who underwent metastasectomy between January 2004 and March 2024. Demographic, clinical, and surgical data were collected. Postoperative functionality was assessed using the MSTS score. Local recurrence, disease progression, and survival were analyzed with a minimum follow-up of 12 months. Kaplan–Meier and log-rank tests were used when appropriate. Results: Thirty patients (73.3% female) were included, with a mean age of 60.4 ± 10.9 years. The most common primary tumors were renal (26.7%) and breast (16.7%). The predominant surgical technique was endoprosthetic reconstruction (50%). Postoperative complications occurred in 40% (12/30), mainly infections (41%). Among 13 patients with recorded functionality, the moderate MSTS category was most common (53.8%), with no significant associations found with the evaluated clinical or surgical variables (all p > 0.10). During follow-up, 19 patients (63%) developed metastatic progression, 2 (6.7%) developed local recurrence, and 11 (36.6%) remained progression-free. The overall survival rate at 12 months was 65%, with a median follow-up of 12 months. Conclusion: Metastasectomy in patients with solitary bone metastases is a safe and effective procedure, yielding good functional outcomes and acceptable rates of disease progression and mortality. Its inclusion in multidisciplinary management should be considered in appropriately selected patients.
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    Pelvic Metastatic Disease: A Novel Technique for Reconstruction of the Posterior Acetabular Column
    (Seth Leopold, 2024-10-11) Ramírez Jaramillo Andrés Felipe; Arroyave Rivera Sergio Andres; Franco Betancur Andrea; Gómez Mier Luis Carlos; Soto Montoya Camilo
    Abstract Background: Pelvic metastases often lead to significant morbidity due to acetabular destruction. Conventional methods may lack adequate support for the posterior acetabular column. This study evaluates a novel technique involving a retrograde ischioacetabular Schanz nail combined with the modified Harrington technique for enhancing stability in total hip arthroplasty (THA) Surgical technique description: After intralesional resection of the acetabular metastatic lesion, we use an ischiatic counter incision to drill a Schanz pin along the posterior acetabular column. Then, we augment the osseous defect with polymethyl methacrylate and total hip arthroplasty, according to each patient compromise we add acetabular reinforcement rings or cages. Methods: We reviewed records of 10 patients with harrington type II-IV lesions treated with this technique at Instituto Nacional de Cancerología from 2017 to 2023 at the Musculoskeletal tumors unit in Instituto Nacional de Cancerología, Bogota, Colombia. Using data acquired from medical history, we identified pain using VAS score in a follow up to 9 months. Outcomes measured included pain control (Visual Analog Scale) and functionality (Karnofsky Performance Status). Follow-up data, including radiological assessments and surgical notes, were analyzed for complications and reconstruction effectiveness Result: Mean patient age was 59.2 years, with 70% female. Average survival was 18.9 months, with follow-up averaging 21.1 months. All patients showed improved pain control (100%), with six achieving full independence. No major complications or revisions were necessary. The longest survivor remains well at 7 years postoperatively Discussion: The technique provides enhanced stability and reduces the need for revision, offering significant pain relief and structural support. It is effective for both short- and long-term survival patients with pelvic metastases. Conclusion: The retrograde Schanz nail in the modified Harrington technique offers a reproducible and effective method for acetabular reconstruction in pelvic metastases, providing durable support and pain relief.